Insurance Verifier-8110

· Provides excellent customer service and adheres to the Behavioral Expectations Agreement.

· Verifies insurance coverage and obtains necessary authorization on observation and inpatient accounts within 24 hours or the next working day (to include completing DES applications for self-pay patients.) Obtains extensions as appropriate.

· Conducts financial counseling and collect patient liability amounts.

· Protects the patients and the hospital financial reimbursement by inputting authorization information, verifies the insurance and ensures that all notification/ authorizations are completed according to financial class department policy.

· Conducts duties in order to protect the financial integrity of the hospital.

· Provides guidance and instructions in the interpretation of admitting policies, procedures and practices.

· Inputs notes pertinent to financial information to assist billing department in payment of the claim and drops insurance flags on accounts.

· Contacts responsible party of inpatient accounts either in person or by telephone to advise of insurance coverage rate when insurance does not cover 100%.

· Professionally advises responsible party of payment requirements and follows hospital policy in establishing payment arrangements.

· Completes self-pay assistance applications when appropriate. Preferably prior to discharge.

· Audits all inpatient files to ensure that insurance cards, orders and other admission documents are complete and copied as needed for scanning.

· Ensure admissions documents are scanned and perform Quality Assurance audits on your scanned documents prior to destroying.

· Maintains statistical information and completes month end stats timely (by the 4th day of the following month) and accurately.

· Maintain admission reports daily (billing error report – admissions/discharge summary).

· Consistently demonstrates a willingness to assist co-workers in a courteous manner to support department efficiency.

· Ability to flex into admitting representative tasks at any given notice.

· Performs and communicates in a highly professional manner at all times.

· Consistently demonstrates the ability to assess a situation from a variety of perspectives.

· Considers alternatives and chooses the most appropriate course of action.

· Other duties as assigned.

· Monitors communication with patients regarding their admission, ensures positive outcome, safeguards the public image of the hospital.

· Demonstrates enthusiasm and self-motivation in performing job duties.

· Excellent customer service skills, and the ability to communicate effectively with others.

· Manage multiple priorities and tasks.

· Maintain attention to detail.

· Ability to organize and sort the daily workload while utilizing effective interpersonal skills through both telephone and face to face contact.

· Knowledge of and have the ability to use computer hardware and software applications.

· Knowledge of medical insurance, managed care and basic business office functions.

Education: High school diploma or equivalent

Experience: Minimum of two (2) years in hospital or medical office business setting

Education: Some college education preferred.

Experience:

· Financial counseling experience.

· Insurance billing and medical terminology.

Exposure Categories: Category II: Expected duties have possible, but not routine, potential for exposure to blood, body fluids or tissues

· Position requires sedentary work, occasionally carrying small objects short distances.

· Must be able to sit at a terminal for up to seven (7) hours daily.

· Must be able to bend, stoop and reach for files and supplies.

· Must be able to get up from chair regularly to get paperwork.